Provider Demographics
NPI:1306174503
Name:SWISHER BEHAVIORAL HEALTH SERVICES, INC
Entity type:Organization
Organization Name:SWISHER BEHAVIORAL HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:SWISHER
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSEDPSYCHOLOGIST
Authorized Official - Phone:814-644-8766
Mailing Address - Street 1:5357 ACORN DR
Mailing Address - Street 2:
Mailing Address - City:HESSTON
Mailing Address - State:PA
Mailing Address - Zip Code:16647-8353
Mailing Address - Country:US
Mailing Address - Phone:814-644-8766
Mailing Address - Fax:814-658-3551
Practice Address - Street 1:373 FAIRGROUNDS RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-1270
Practice Address - Country:US
Practice Address - Phone:814-644-8766
Practice Address - Fax:814-658-3551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-27
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS 007785-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1017965620001Medicaid
PA1018572650001Medicaid
PA0016140950005Medicaid